The impact of task-oriented training on hand functionality in children with cerebral palsy under 18 years: a systematic review and meta-analysis

TL;DR

Task-oriented training improves hand function, grip strength, and cognitive abilities in children with cerebral palsy compared to standard rehabilitation.

Contribution

A systematic review and meta-analysis confirming the efficacy of task-oriented training for hand rehabilitation in cerebral palsy.

Findings

Task-oriented training significantly improved hand function compared to standard treatment.

Children showed better grip strength and cognitive improvements with task-oriented training.

Functional independence, as measured by the WeeFIM Scale, was higher in the task-oriented group.

Abstract

Task-oriented training (TOT) is the predominant rehabilitative training approach grounded in motor control theory. The effectiveness of treating hand dysfunction in children with cerebral palsy has not been established. This research conducts a systematic analysis of the rehabilitation treatment effects of TOT on hand dysfunction in children with cerebral palsy.

Comprehensive searches were performed in databases including China National Knowledge Infrastructure, Wan Fang Database, Chinese Science and Technology Periodical Databases, SinoMed, PubMed, Web of Science, Embase, and Cochrane Library for randomized controlled trials of TOT utilized in the rehabilitation of hand dysfunction in pediatric patients with cerebral palsy. The control group underwent standard rehabilitation treatment, but the experimental group received TOT alongside the control group treatment. The search time concluded in August 2025, coinciding with the establishment of each database. Two researchers independently performed literature screening and data extraction, while the quality of the literature was assessed using the Cochrane risk of bias assessment tool. A meta-analysis was conducted with Revman 5.4 software.

Sixteen publications were included, encompassing 1,037 children with cerebral palsy. The meta-analysis indicated that the enhancement of hand function in the experimental group surpassed that of the control group [SMD = 1.44, 95% CI (1.12, 1.76), p < 0.01]. Additionally, the recovery of grip strength and cognitive ability was superior in the experimental group [SMD = 0.52, 95% CI (0.17, 0.87), p < 0.05; MD = 0.93, 95% CI (0.60, 1.27), p < 0.01]. Furthermore, the WeeFIM Scale score for the experimental group exceeded that of the control group [MD = 6.47, 95% CI (5.22, 7.72), p < 0.01].

TOT can boost the manual dexterity of children with cerebral palsy, and improve their grip strength and cognitive abilities. It is also more efficacious in enhancing the functional autonomy of youngsters. It is important to highlight that certain markers of the overall sample size, such as grip strength and IQ, were featured in only three publications, resulting in inadequate statistical power. Future research necessitates further large-sample, high-quality randomized controlled trials to validate the aforementioned conclusions.

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